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구개상악재건을 위한 유리피판술에서 다양한 공여부의 선택

Other Titles
 Selection of Varoius Free Flap Donor Sites in Palatomaxillary Reconstruction 
 윤도원  ;  민희준  ;  김지예  ;  이원재  ;  정섬  ;  정윤규 
 Journal of the Korean Society for Microsurgery (대한미세수술학회지), Vol.20(1) : 8-13, 2011 
Journal Title
Journal of the Korean Society for Microsurgery(대한미세수술학회지)
Issue Date
Deglutition ; Fistula ; Follow-Up Studies ; Forearm ; Free Tissue Flaps ; Head and Neck Neoplasms ; Humans ; Nasal Cavity ; Palate ; Rectus Abdominis ; Retrospective Studies ; Skin ; Speech Disorders ; Tissue Donors
Free flap ; Palatal defect ; Palatomaxillary
PURPOSE : A palatal defect following maxillectomy can cause multiple problems like the rhinolalia, leakage of foods into the nasal cavity, and hypernasality. Use of a prosthetic is the preferred method for obturating a palate defect, but for rehabilitating palatal function, prosthetics have many shortcomings. In a small defect, local flap is a useful method, however, the size of flap which can be elevated is limited. In 12 cases of palatomaxillary defect, we used various microvascular free flaps in reconstructing the palate and obtained good functional results.

METHOD : Between 1990 and 2004, 12 patients underwent free flap operation after head and neck cancer ablation, and were reviewed retrospectively. Among the 12 free flaps, 6 were latissimus dorsi myocutaneous flaps, 3 rectus abdominis myocutaneous flaps, and 3 radial forearm flaps.

RESULT : All microvascular flap surgery was successful. Mean follow up time was 8 months and after the follow up time all patients reported satisfactory speech and swallowing. Wound dehiscence was observed in 4 cases, ptosis was in 1 case and fistula was in 1 case, however, rhinolalia, leakage of food, or swallowing difficultly was not reported in the 12 cases.

CONCLUSION : We used various microvascular flaps for palatomaxillary reconstruction. For 3-dimensional flap needs, we used the latissimus dorsi myocutaneous flap to obtain enough volume for filling the defect. Two-dimensional flaps were designed with latissimus dorsi myocutaneous flap, rectus abdominis flap and radial forearm flap. For cases with palatal defect only, we used the radial forearm flap. In palatomaxillary reconstruction, we can choose various free flap techniques according to the number of skin paddles and flap volume needed.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Won Jai(이원재) ORCID logo https://orcid.org/0000-0003-3056-0503
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